nightflight1945
banned
Topics: 32
Posts: 920
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Which of the following could falsely depress the serum amylase level in a patient suspected of having acute pancreatitis?
A. Associated intestinal infarction
B. Associated pleural effusion
C. Hypercholesterolemia
D. Hypertriglyceridemia
E. Hypocalcemia
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| dr.wad
Forum Senior
Topics: 3
Posts: 350
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D..
i want to add a comment ...>>hypertriglyceredemia is a cause of pancreatitis espicially when serum triglyceride > 1000 mg/dl.
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| DrAlex_76
Forum Guru
Topics: 120
Posts: 410
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It's in Harrison,- " pts with hyperTG occurs in 15-20 % and serum amylase levels in these individuals are often spuriously normal. Dun u think this kinda Q is so detail ?
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| docdoc9
Forum Guru
Topics: 63
Posts: 513
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Hypertriglyceridemia compounds the diagnosis of acute pancreatitis by causing spuriously normal amylase levels.[3] Plasma triglyceride levels higher than 500 mg/dL interfere with in vitro determination of the actual amylase level by preventing the calorimetric reading of the assay end point.[2] Serial dilutions of the patient's sample with the assay buffer to reduce interference of light transmission by hyperlipidemic serum can reveal an abnormal amylase value that was previously masked by the lactescent plasma.[3] Other studies investigating the potential role of circulating amylase inhibitors have not been well substantiated.[9,10] Alternatively, patients with hypertriglyceridemia can also have a more insidious course of disease progression than other patients with acute pancreatitis, resulting in normalization of amylase levels by the time they seek medical help.[8]
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| docdoc9
Forum Guru
Topics: 63
Posts: 513
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Reference
http://www.medscape.com/viewarticle/417837_3
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